1／3剂量维替泊芬光动力疗法治疗慢性CSC的远期疗效观察  

Long-term results of photodynamic therapy with one third standard dose verteporfin for chronic central serous chorioretinopathy（CSC）

作　　者：邹玉凌[1] 游志鹏[1] 

机构地区：[1]江西省南昌市南昌大学第二附属医院眼科, 江西330008

出　　处：《中国实用眼科杂志》2013年第4期460-463,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨1／3剂量维替泊芬光动力疗法治疗慢性中心性浆液性脉络膜视网膜病变（CSC）的远期疗效。方法结合患者病史和眼底检查、光学相干断层成像（OCT）、眼底荧光血管造影（FFA）及吲哚菁绿血管造影（ICGA）检查，诊断为慢性CSC患者43例45只眼，采用1／3剂量维替泊芬光动力疗法（PDT）治疗，维替泊芬注入10min后，在吲哚菁绿的引导下激光照射83s。术后随访18—36个月，平均26．7个月，随访期问进行最佳矫正视力、OCT、FFA和ICGA检查。结果术后1个月，最佳矫正视力平均0．45，3个月时为0．54，6个月时为0．63，12个月时为0．70；末次随访时最佳矫正视力0．2～1．0，平均0．72，42只眼视力得到提高，占93％，其余3只眼视力稳定，无一眼出现视力下降。45只患眼视功能均有改善，视物变形等症状消失或好转。术后OCT、FFA、ICGA检查3个月时显效均在80％以上，术后6个月时100％显效，至末次随访时未见复发病例及PDT治疗相关的并发症。结论1／3剂量维替泊芬PDT治疗慢性Csc具有良好的远期疗效，但该治疗方法的安全性和有效性还有待于多中心随机对照试验研究的进一步证实。Objective To observe the long-term results of photodynamic therapy with one third standard dose verteporfin for chronic central serous chorioretinopathy （CSC）. Methods Forty-five eyes of 43 patients diagnosed as chronic CSC by the examination of fundus, optical coherence to- mography （OCT）, fundus fluorescein angiography （FFA） and indocyanine green angiography （ICGA）, underwent photodynamic therapy （PDT） with one third standard dose verteporfin by means of specif- ic laser slit lamp. Verteporfin was infused over 10 minutes followed by ICGA guiding laser applica- tion for 83 seconds. Postoperatively, all patients were followed up for 18-36 months, meanly 26.7 months. During the time of follow-up, examinations included best corrected visual acuity （BCVA）, OCT, FFA and ICGA. Results At one month after PDT, the average BCVA was 0.45,0.54 at 3 months, 0.63 at 6 months, 0.70 at 12 months; the last follow-up, BCVA was from 0.2 to 1.0, mean- ly 0.72, the BCVA increased curiously in 43 eyes （93%）, stabilized in 3 eyes, decreased in no one eye. The postoperative OCT, FFA, ICGA had regressed in above 80% eyes at 3 months, in all eyes （100%） after 6 months, there were no recurrence and ocular and systemic complications until the fi- nal follow-up. Conclusions Photodynamic therapy with one third standard dose verteporfin for chronic CSC has a good long-term results, but further multi-center randomized controlled trial study is warranted to demonstrate the safety and efficacy of the treatment.

关 键 词：慢性中心性浆液性脉络膜视网膜病变 光动力疗法 维替泊芬 远期疗效 

分 类 号：R135.2[医药卫生—劳动卫生]